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Management of Malaria in Pregnant Women at the Maternity Unit of the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) in Ouagadougou: About Report on the Quality of Care

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1337-1344页

作者： Ouattara Adama Ouédraogo Smaila lankoandé bako coulibaly natacha Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba Bonané Blandine Training and Research Unit in Health Sciences (TRU/HS) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objective: To do a report on the quality of the treatment of malaria in pregnant women at University Teaching Hospital Yalgado Ouedraogo (UTH-YO) in Ouagadougou. Materials and Methods: This was a descriptive cross-sectional study conducted from 29 July to 02 October 2016. The targets were pregnant women and gynecology and obstetrics service care providers. The study used an individual questionnaire administered and clinical parasitological research by the Rapid Diagnostic Test (RDT). Some information was verified in the patient’s prenatal consultation logbook. A total of 351 women and 44 providers participated in the study. The data was captured on a microcomputer and analyzed using Epi info version 7 software. Results: Regarding preventive measures, patients’ responses were correct for long-lasting impregnated mosquito net (LLIN) in 98.8% of cases and for intermittent preventive treatment (IPT) in 96.5% of cases. About providers, they had given a good answer in all cases for using LLIN and taking IPT. Regarding care providers’ knowledge of the clinical signs of malaria, fever was cited in 95.5% of cases for simple malaria and Frankish jaundice in 97.7% of cases for severe malaria. With regard to curative treatment, 77.3% of the care providers surveyed stated that quinine was the reference molecule for the treatment of simple malaria in pregnant women. In terms of the availability of inputs used for malaria management, our survey found no RDTs. Also, the only molecule available was quinine in its compressed and injectable forms. Conclusion: Care Providers’ and patients’ knowledge of malaria in the obstetrics and genecology department is quite satisfactory. However, some shortcomings were noted in the provision of screening and curative and preventive treatment. The elimination of malaria in our country will require joint efforts at all levels.

关键词： Malaria Pregnancy Treatment UTH-YO

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Causes of Maternal Mortality According to Reports of Maternal Death Audits in the University Teaching Hospital Bogodogo (UTH-B) from January to December 2017

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1345-1353页

作者： Ouattara Adama Ouédraogo Smaila lankoandé bako coulibaly natacha Kain Dantola Paul Tougma Sanou Aline Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba Bonané Blandine Training and Research Unit in Health Sciences (TRU/HS) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objective: To study causes of maternal mortality according to reports of maternal death audits in the University Teaching Hospital Bogodogo (UTH-B) of Ouagadougou, Burkina Faso. Materials and Method: This was a prospective study that took place over a year from 1 January to 31 December 2017.? It concerned maternal deaths that occurred during this period in the obstetrics and gynecology department of the University Teaching Hospital Bogodogo (UTH-B). All maternal deaths were systematically audited by the audit committee;interviews with providers and families were sometimes conducted. The record books of all patients were analyzed by the audit committee;if necessary, interviews were conducted with care providers and families. The main information collected were recorded on individual files, entered and analyzed using the software Epi-info 7. Result: During the study period, we recorded 32 maternal deaths i.e., 587 per 100,000 live births. Deceased women under age 20 were the most numerous, followed by women aged 20 to 24. The death occurred in most cases in the puerperium in 69.80% of cases. Complications of pregnancy were the most incriminated causes in maternal deaths. Bleeding was the leading cause, accounting for 34.3%. They are followed by hypertensive disorders of pregnancy (21.8%) and infections (18.8%). In the contributing factors, resource factors were incriminated in 56.2% of cases, social factors in 43.7% of cases and medical factors in 25.4% of cases. Death was non-preventable in 76.2% of cases compared to 23.8% of preventable deaths. Conclusion: Maternal mortality is a major public health problem at the maternity hospital of the university hospital Yalgado Ouedraogo. Hemorrhage is the first cause of death. Hypertensive diseases are more and more worrying. Solutions must be found to improve the practice of audits in the obstetrics and gynecology department of UTH-B.

关键词： Audits Review Maternal Deaths Causes of Maternal Deaths

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C1C2 Wiring and Posttraumatic Atlantoaxial Dislocation: An Effective and Cheap Surgical Procedure in a Developing Country

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Surgical Science 2024年第5期15卷 357-370页

作者： Ibrahim Dao Massimiliano Visocchi Salah Sow John Jabang Ousmane Ouattara Astride Somda Abdoulaye Sanou Elie Dibloni Nassoum Arsène Tossou Narcisse Ouedraogo Frédéric bako Massadiami Soulama Malick Diallo Patrick Wendpouiré Hamed Dakouré Department of Neurosurgery University Hospital Souro Sanou Nazi Boni University Bobo Dioulasso Burkina Faso High Institute of Health Sciences Nazi Boni University Bobo Dioulasso Burkina Faso Military Hospital Colonel Major Tanguet Ouattara Bobo Dioulasso Burkina Faso Institute of Neurosurgery Craniovertebral Junction Surgery Unit School of Medicine Catholic University Rome Italy Department of Radiology and Medical Imaging University Hospital Yalgado Ouedraogo Joseph Ki-Zerbo University Ouagadougou Burkina Faso Department of Neurosurgery (Unit) Edward Francis Small Teaching Hospital Banjul Gambia Department of Neurosurgery University Hospital Yalgado Ouedraogo Joseph Ki-Zerbo University Ouagadougou Burkina Faso Department of Neurosurgery Military Hospital Capitaine Halassane Coulibaly Ouagadougou Burkina Faso Department of Orthopedic Surgery University Hospital Souro Sanou Nazi Boni University Bobo Dioulasso Burkina Faso

Objectives: Atlantoaxial dislocation remains a rare and serious condition with a high preoperative and postoperative morbidity and mortality. Its successful surgical management is still challenging and gratifying for neurosurgeons. Several technics have been described such as wiring, trans articular screwing, C1C2 screwing with plate and screw introduced by Goel et al., and modified by insertion of polyaxially screw and rod many years later by Harms. Unavailability and expensiveness of upper cervical spine instrumentation device led us to C1C2 Wiring resulting in a good outcome. Finally, a quadriplegic patient with a more comfortable financial condition had ordered devices from abroad and benefit for Goel and Harms screwing technique and improved dramatically from ASIA A to ASIA E. Material and methods: This is a retrospective study of patients managed in our department by a same neurosurgeon from January 2019 to April 2024. Results: We defined 6 men and 1 woman with an average age of 33 years. Unrestrained driver in a rollover motor vehicle accident was most common. Only one patient was neurologically intact on admission. Neurovegetative disorders were noticed in one patient. Dislocation was associated to a fracture of the dens in two patients. Three patients have been successfully operated with remarkable outcome, mostly from ASIA A to E. Conclusion: C1C2 dislocation is a serious condition and C1C2 Wiring represents an effective and cheaper technic. Therefore, this technic should deserve consideration above all in low incomes countries when screwing devices are not available. Seatbelt should be demanded for motor vehicle drivers and passengers.

关键词： Superior Cervical Spine Dislocation Fracture Wiring Screwing Neurovegetative Disorders

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Episiotomy: Epidemiological Aspects, Indications and Prognosis in the Bogodogo Health District

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1354-1363页

作者： Ouattara Adama lankoandé bako natacha Ouédraogo Smaila Sawadogo Yobi Alexis Millogo Traoré Francoise Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba Bonané Blandine Training and Research Unit in Health Sciences (TRU/HS) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objectives: To study the epidemiological aspects, indications and short and medium term prognosis of episiotomy in the health district of Bogodogo in Ouagadougou, Burkina Faso. Materials and Method: It was a descriptive prospective study over 4 months from 1 July 2016 to 30 October 2016. It was conducted in 4 health facilities in the health district of Bogodogo in the city of Ouagadougou. The study concerned the patients who gave birth after 28 gestational age (GA) and more, vaginally with episiotomy, in the 4 health facilities and who were reviewed at the appointment of the 9th day and the 3rd month. The data were collected using a questionnaire developed for the purposes of the study, seized with a laptop, then analyzed using the Epi-info software in its 3.5.1 version of the Atlanta C.D.C. Statistical comparisons were made using the Pearson chi-square test, with a significance level of p 0.05. Results: The overall episiotomy rate was 22%. For follow-up, 248 patients were reviewed on the 9th day and 109 patients on the 3rd month. The average age of our patients was 23.1 years. The average number of pregnancies was 1.7 with nulliparous women predominating (60.5% of cases). Excision was associated with episiotomy in 92.3% of cases, with perineal narrowing in 82.5% of patients. The mediolateral episiotomy was the most performed, in 76.6% of patients. Vulvo-perineal stricture was the main indication (75% of cases). The experience during the episiotomy and the evolution following the immediate layer was marked by pain. Dyspareunia was the main difficulty in resuming sexual intercourse. Conclusion: The episiotomy rate in our study was 22%. A program of continuous improvement of the quality of care concerning episiotomy encompassing various actions (audits, training) could reduce the use of episiotomies.

关键词： Episiotomy Epidemiology Bogodogo

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The Role of Ultrasound in the Diagnosis and Management of Trophoblastic Diseases (TMD) at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1376-1388页

作者： Ouattara Adama Ouedraogo Nde Nina Astrid lankoandé bako natacha Tougma Sanou Aline Sawadogo Yobi Alexis Millogo Traoré Francoise Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba Bonané Blandine Training and Research Unit in Health Sciences (TRU/HS) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objective: To describe the place of ultrasound in the diagnosis and management of Gestational Trophoblastic Diseases (GTD) at the Ouagadougou UTH-YO, Ouagadougou, Burkina Faso. Materials and Patients: It was a prospective and descriptive study over a 3-year period from 1 January 2015 to 31 December 2017. It took place in the gynecology and obstetrics department of at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Monitoring was based on clinical examination data, ultrasound and kinetics of β-gestational chorionic hormone (GCH) levels. Results: During the study period, we recorded 34 cases of trophoblastic diseases. The average age of the patients was 35 years with extremes of 22 and 52 years. Physical examination revealed a uterus larger than gestational age in 17 patients (56.67%) of cases. Eight (26.67%) patients were asymptomatic. The initial mean β-GCH was 453,747.8 IU/l with extremes of 5903 IU/l and 1,890,000 IU/l. Ultrasound was used to evoke the diagnosis in 23 patients, that to say 76.67% of the cases. Ultrasound identified 10 complete mole cases, 20 partial mole cases. For the 3 cases of invasive mole, pelvic ultrasound revealed heterogeneous intrauterine multi-vesicular images. In a case of choriocarcinoma, ultrasound found an enlarged uterus with a poorly limited intracavitary heterogeneous fundic image. Conclusion: This short series shows the central role of ultrasound in the diagnosis and follow-up of gestational trophoblastic diseases. Indeed, the sensitivity of ultrasound is excellent in the early diagnosis of complete moles. Ultrasonography remains a good examination choice for the diagnosis of gestational trophoblastic tumors despite their great polymorphism. The place of ultrasound in prognostic evaluation and treatment monitoring deserves to be studied by more important series.

关键词： Gestational Trophoblastic Diseases (GTD) UTH-YO Ultrasound

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Particularities of Pregnancy and Childbirth among Adolescents’ Girls in the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) in Ouagadougou, Burkina Faso

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1389-1398页

作者： Ouattara Adama Ouédraogo Smaila lankoandé bako natacha Tossou Arséne Serge Tougma Sanou Aline Sawadogo Yobi Alexis Millogo Traoré Francoise Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba Bonané Blandine Training and Research Unit in Health Sciences (TRU/HS) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objectives: To study the particularities of pregnancy and childbirth among adolescent girls at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Patients and Method: This was a comparative, descriptive and analytical cross-sectional study conducted over a 6-month period on 138 adolescent girls and 276 adults who gave birth in the obstetrics and gynecology department of the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) in Ouagadougou during the study period from May 1 to October 30, 2017. The statistical analysis had used the Chi square test and the strength of the association was appreciated by the Odds Ratio (OR). The significance threshold was set at 5%. Results: Adolescent girls had an average age of 17.04 ± 0.72 years and 64.49% were married. The majority came from urban areas and was educated. Housewives were more represented with 73.2% and 65.94% of adolescent girls were of low socio-economic status. Concerning the level of education, 48 (34.7%) were out of school, 57 (41.3%) had primary level, 32 (23.2%) secondary level and 1 (0.7%) higher level. Primigravida was the most numerous and only 39 adolescent girls used a contraceptive method. Malaria (p = 0.0247), preeclampsia (p = 0.0008) and anaemia (p = 0.0002) dominated pathologies during pregnancy in adolescent girls. The pelvis was borderline in 10.8% of adolescent girls. For newborns, teenage girls had a lower weight and an Apgar score of less than 7 higher. Perinatal mortality was higher (p = 0.0269). Postpartum outcomes were marked by complications with endometritis type (p = 0.0315) and higher maternal mortality (p = 0.0049). Conclusion: The teenagers’ pregnancy experience is marked by high maternal and perinatal morbidity and mortality. The promotion of contraception among adolescents should help to resolve this unpleasant situation.

关键词： Teen Pregnancy UTH-YO Burkina Faso

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Quality Control of First Trimester Ultrasound Examinations in the Gynecology and Obstetrics Department of the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou, Burkina Faso

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1399-1413页

作者： Ouattara Adama Nde Ouédraogo Nina Astrid lankoandé bako natacha Ouédraogo Smaila Nare Amelie Tougma Sanou Aline Sawadogo Yobi Alexis Millogo Traoré Francoise Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba Bonané Blandine Training and Research Unit in Health Sciences (TRU/HS) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objective: To evaluate the quality of first trimester ultrasound examinations in patients consulting in the gynecology and obstetrics department at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Method: Our study took place from January 1st to March 31st 2017, in the department of Obstetrics and Gynecology of the University Teaching Hospital Yalgado Ouedraogo of Ouagadougou. This was a descriptive study on the records of the first trimester ultrasound of pregnancy, with analysis of the iconography. We used the criteria of the Technical Committee of Fetal Echography (TCFE) of France to analyse all the ultrasound reports brought by the patients. Results: Two hundred reports were collected in three months. In terms of ultrasound identification, only 2 reports out of 200 mentioned the brand and date of first circulation and 4 specified the type of device. The study of the quality of the appointment showed that only 52% of the ultrasounds had been performed at the right time, between 11SA - 14SA of amenorrhea. For the nuchal translucency quality, we rated by the Herman score, 41.67% of the scores were of “unacceptable” quality and only 58.33% were of “acceptable” quality we did not achieve “excellent” quality. The analysis of the biparietal diameter (BIP) cuts revealed that 1/4 only anatomical cuts had been well made. Analysis of the cranio caudal length (CCL) cuts showed that only 14.58% of the CCLs had been well done. Elements of early morphology had been explored to less than 5%. Conclusion: The results revealed the acceptable quality of the NC measurements, but a small proportion of NC achieved. The quality of the ultrasound, morphological analysis and biometrics period is not very acceptable.

关键词： Ultrasonography First Trimester Reports UTH-YO

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Quality Control of Second Trimester Ultrasound Examinations in the Gynecology and Obstetrics Department of the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou, Burkina Faso

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1324-1336页

作者： Ouattara Adama Nde Ouédraogo Nina Astrid lankoandé bako natacha Ouédraogo Smaila Bayala René-Philippe Yi Dia Tougma Sanou Aline Sawadogo Yobi Alexis Millogo Traoré Francoise Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba Bonané Blandine Training and Research Unit in Health Sciences (TRU/HS) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objective: To evaluate the quality of second trimester ultrasound examinations in patients consulting in the gynecology and obstetrics department at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Method: Our study took place from January 1st to March 31st 2017, in the department of Obstetrics and Gynecology of the University Teaching Hospital Yalgado Ouedraogo of Ouagadougou. This was a descriptive study on the records of the second trimester ultrasound of pregnancy, with analysis of the iconography. We used the criteria of the Technical Committee of Fetal Echography (TCFE) of France to analyse all the ultrasound reports brought by the patients. Results: Three hundred ultrasound reports were collected over three months. It revealed that, in terms of patient identification, 100% of the reports bore the surname and first name of the pregnant woman;88% and 94.67% of the ultrasound scans bore the surname and first name of the ultrasound specialist respectively. Only 2% presented the brand and type of ultrasound scanner. The study of the quality of the appointment showed that 52% of the ultrasounds had been performed at the right time, between 20 Gestational Age (GA) and 25 GA. For the quality of the iconography, referring to the recommendations of the Technical Committee of Fetal Echography (TCFE) of France and taking into account the data confirmed by the literature, we found that the quality was slightly acceptable either respectively for biometric and morphological sections. Conclusion: The quality of the ultrasound reports of the second trimester ultrasounds in patients consulting in the obstetrics and gynecology department of the University Hospital Yalgado OUEDRAOGO was not totally satisfactory.

关键词： Ultrasonography Second Trimester Reports UTH-YO

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Clinical Performances of Pure TB-Lamp Kit for <i>M. tuberculosis</i>Complex Detection in Sputum Samples

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Journal of Tuberculosis Research 2017年第2期5卷 129-138页

作者： Kouassi N’guessan Jacob Adegbele Ibrahima coulibaly natacha Kouame-N’takpé Hortense Seck-Angu André Guei Jacquemin Kouakou Mireille Dosso Laboratoire Nationale de Référence de la Tuberculose Institut Pasteur de C&ocirc te d’Ivoire Abidjan C&ocirc te d’Ivoire Centre Antituberculeux de Yopougon Abidjan C&ocirc te d’Ivoire Programme National de Lutte contre la Tuberculose Abidjan C&ocirc te d’Ivoire

Tuberculosis represents a main concern for public health worldwide. In poor countries, the most prevalent method for bacteriological confirmation re- mains Smear Sputum Microscopy (SSM). This study objective was to assess clinical performances of Loop Mediated Isothermal Amplification for TB detection (Lamp-TB). Sputum of patients presenting symptoms consistent with tuberculosis were collected according to the National Tuberculosis Control Programme guidelines in Centre Antituberculeux de Yopougon. SSM after Ziehl-Neelsen staining and TB-Lamp were blindly performed with spot sputum specimen. Samples, transported at Institut Pasteur de Cote d’Ivoire were decontaminated according to N-acetyl-L-cystein (NALC) method. In Mycobacteria Growth Indicator Tube (MGIT), 500 μl of pellet were inoculated and incubated in MGIT 960 instrument. MPT64 antigen was detected on positive culture. Of 500 patients enrolled, 469 were included. Clinical isolates of M. tuberculosis Complex were detected for 157 (33.5%). Comparatively to culture, Sensitivity and Specificity of SSM were 86% (95% Confidence interval (CI): 81% - 91%) 96% (95%IC: 94% - 98%) respectively. TB-Lamp Sensitivity was 92% (95%CI: 88% - 96%), and Specificity 94% (95%CI: 91% - 97%). Positive Predictive Value of SSM and TB-Lamp was 91.8% and 88.8% respectively. Negative Predictive Value of TB-Lamp assay was 95.7% whereas this of SSM was 93.3%. Positive Likelihood Ratio was 15.3 for TB-Lamp and 21.5 for SSM 21.5 whereas negative Likelihood of TB-Lamp was lower than SSM. Active tuberculosis was detected in162/469 (34.5%) with TB-Lamp and 147 (31.3%) with SSM. TB-Lamp assay performances estimated from sputum samples may improve detection of active TB cases in routine.

关键词： Tuberculosis Ziehl-Neelsen TB-Lamp Assay

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